Turkish archives of pediatrics最新文献

Objective: Celiac disease (CD) is a gluten-associated enteropathy whose incidence has been increasing in recent years. Parents whose children are diagnosed with CD search for information about the disease via the internet. YouTube is one of the most frequently used platforms to access information due to the number of users and ease of access. This study aims to investigate how much quality and reliable information the most frequently viewed videos contain for families seeking information about celiac disease in children via YouTube. Materials and Methods: On November 13, 2023, a global search for "Celiac in Children" was conducted on YouTube. The first 150 videos were evaluated using the most frequently watched video filter, and 86 eligible videos were included in the study. Journal of the American Medical Association (JAMA), Global Quality Scale (GQS), and modified DISCERN (ModDISCERN) scoring were performed for quality and reliability of the videos. Results: Thirty-five of the videos (40.7%) were related to childhood CD. When analyzed according to the upload source, 67 (77.9%) were created by healthcare professionals (doctors, nurses, dietitians, etc.) and 19 (22.1%) by independent users. Of all videos, 62% were of very poor and poor quality (1 and 2 points). Videos created by healthcare professionals had higher JAMA scores, GQS scores, and ModDISCERN scores (P = < .001/P =< .001/P =< .001/P =< .001/P =< .001/P =< .001, respectively). Conclusion: The quality and reliability of the most frequently watched YouTube videos about CD in children were generally low. At this point, analyzing videos on medical topics by experts and adding them to the search algorithm according to the scores will help users access reliable information.

Objective: The personal experiences of breastfeeding healthcare workers may influence the quality of breastfeeding support provided. This study explored the breastfeeding experiences of nurses and support staff in South India. Materials and Methods: A qualitative exploratory study using focus group discussions (FGDs) was conducted among nurses and support staff of a newly established tertiary care hospital in South India. Purposive sampling was used, and written consent was obtained. Three FGDs were conducted in English and in local language by trained personnel. Audio recordings were transcribed, coded using Atlas Ti, and analyzed thematically. New themes from each FGD were integrated into later discussions until saturation was achieved in the third FGD. Results: Participants, primarily aged 30-35 years, encountered cultural pressures, fears of job loss, and insufficient workplace support while breastfeeding. Maternity leave varied with some participants having experienced job loss. Facilitators for exclusive breastfeeding included support from colleagues and friends, private lactation rooms, and adequate leave. Harmful cultural practices suggested limited health literacy. Reduced milk supply, lack of awareness about expressed milk, inadequate storage facilities, and job stress led to a preference for bottle feeding. Participants also highlighted a lack of spousal understanding concerning shared responsibilities and sexual intimacy following delivery. They expressed a desire for paid leave with job security, designated breastfeeding areas, and the normalization of public breastfeeding. Conclusion: Breastfeeding challenges for nurses and support staff in South India stem from societal pressures and work demands. This study emphasizes the need for multi-level interventions to empower them in effective breastfeeding practices.

Objective: Urinary stone disease (USD) is characterized by stone formation in the urinary system with an approximate prevalence of 5%-10% in children. In thisr study, the authors investigated the metabolic abnormalities that play a role in stone formation in pediatric patients with USD admitted to the authors' pediatric nephrology clinic during the last 10 years, the demographic characteristics of the patients, and the presenting symptoms. Materials and Methods: A total of 325 pediatric patients, 166 boys (51.1%) and 159 girls (48.9%), who presented to the Pediatric Nephrology outpatient clinic of the authors' center with a prediagnosis of USD were retrospectively analyzed. Results: Of 325 patients, 159 (48.9%) were female and 166 (51.1%) were male. The median age at diagnosis was 29 (0-229) months. 188 (57.9%) of the patients had a positive family history of USD and 22 (6.8%) had parental consanguinity. Hypocitraturia was found in 26.2% and hypercalciuria in 17.5% of patients. Stones were detected in 198 patients (60.9%) in the initial ultrasonography (USG) evaluation. Stones were most commonly located in the renal pelvis (75.8%) followed by the ureter (10.1%) and both renal pelvis and ureter (3%). About 40.4% of the stones were located in the left side, bilaterally in 37.8%, and 21.2% in the right side. Conclusion: Urinary stone disease is common in children. Unlike adult patients, patients with a positive family history of USD and parental consanguinity necessitate further metabolic evaluation and should be investigated for underlying urinary tract infection. Identifying stone disease early in childhood can help us detect urinary tract and metabolic abnormalities earlier.

Objective: Prolidase deficiency is a metabolic and immunological disorder that is inherited in an autosomal recessive manner. In prolidase deficiency, a broad spectrum of differences is observed in patients, ranging from asymptomatic to multisystem involvement. There is scarce information in the literature on the atypical features and immunophenotypes of this disease. Aim of this study is to present 4 new cases to provide information on the rare features of the disease and to raise awareness. Materials and Methods: This study included 4 female patients with prolidase deficiency. Their demographic, clinical, and immunologic characteristics were obtained from their medical records. Results: There were 4 female patients (P1-P4), with a mean age of 18.5 years (min-max: 10-29) and a mean age of symptom onset of 6.9 years (min-max: 0.04-27). The main presenting complaints of the patients were skin lesions (100%), dysmorphic features (100%), neurodevelopmental delay (100%), frequent infections (100%), and prolonged diarrhea (50%). P2 had diffuse large B-cell lymphoma, resulting in early death. Interestingly, P1 and P2 experienced opportunistic infections such as cytomegalovirus, Epstein-Barr virus, and Pneumocystis jirovecii. Three patients (75%) had lymphopenia. Two patients had elevated IgE levels. Lymphocyte subgroup analysis showed an inverted CD4/CD8 ratio in all patients. In patients P1 and P2, the percentages of naive T cells and recent thymic emigrants were reduced, suggesting combined immune deficiency at the time of diagnosis. CD19+ B cells were also low in P1 and P2. Metabolic evaluations revealed low prolidase enzyme activity in P1 and P2. Conclusion: Beyond the well-known classical dermatological findings, the presence of recurrent opportunistic infections, gastrointestinal involvement, malignancy, and flow cytometry findings suggestive of combined immunodeficiency indicate that the diagnosis of prolidase deficiency may be underestimated. Knowing the atypical and rare presentations will facilitate diagnosis and treatment of affected patients.